Is It Beneficial to Involve a Family Member? A Meta-Analysis of Psychosocial Interventions for Chronic Illness.

University of Pittsburgh, Department of Psychiatry and University Center for Social and Urban Research, Pittsburgh, PA 15260, USA. .
Health Psychology (Impact Factor: 3.59). 12/2004; 23(6):599-611. DOI: 10.1037/0278-6133.23.6.599
Source: PubMed


Links between chronic illness and family relationships have led to psychosocial interventions targeted at the patient's closest family member or both patient and family member. The authors conducted a meta-analytic review of randomized studies comparing these interventions with usual medical care (k=70), focusing on patient outcomes (depression, anxiety, relationship satisfaction, disability, and mortality) and family member outcomes (depression, anxiety, relationship satisfaction, and caregiving burden). Among patients, interventions had positive effects on depression when the spouse was included and, in some cases, on mortality. Among family members, positive effects were found for caregiving burden, depression, and anxiety; these effects were strongest for nondementing illnesses and for interventions that targeted only the family member and that addressed relationship issues. Although statistically significant aggregate effects were found, they were generally small in magnitude. These findings provide guidance in developing future interventions in this area.

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    • "There may be the potential to consider family level interventions for musculoskeletal conditions. For example, Martire et al., 2004 demonstrate , in a review and meta-analysis of family level interventions, that positive effects on outcomes (e.g. index condition for patient, psychological outcomes for patient and family member) are present in both the patient and family member if a family member is involved in the treatment process. "
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    ABSTRACT: Musculoskeletal pain conditions are common and create substantial burden for the individual and society. While research has shown concordance between couples for risk of some diseases, e.g. heart disease or diabetes, little information is available on such effects for musculoskeletal pain conditions. Our aims were to investigate the presence of concordance between couples for consultations about pain, and to examine theoretical influences on such concordance. This was a 1-year cross-sectional study of musculoskeletal pain consultations in a UK primary care database. In total 27,014 patients (13,507 couples) aged between 30 and 74 years were included. The main outcome measure was the presence of a musculoskeletal morbidity read code indicating a consultation for musculoskeletal conditions (any, back, neck, knee, shoulder, foot, osteoarthritis). Logistic regression was used to test associations with odds ratios (OR) and 95% confidence intervals (95% CI). Patients whose partner had a musculoskeletal pain consultation were also more likely to consult for a musculoskeletal condition (OR 1.22, 95% CI 1.12-1.32). This association was found to be strongest for shoulder disorders (OR 1.91, 95% CI 1.06-3.47). No significant associations were found for other pain conditions. Results show that partner concordance is present for consultations for some musculoskeletal conditions but not others. Possible explanations for concordance include the shared health behaviours between couples leading to potential heightened awareness of symptoms. Given the high prevalence of musculoskeletal pain within populations, it may be worth considering further the mechanisms that explain partner concordance. © 2015 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®
    European Journal of Pain 07/2015; Early View. DOI:10.1002/ejp.744 · 2.93 Impact Factor
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    • "Although research findings and system theories suggest that chronic illness has an impact on the family as a unit, the health care system is typically patient focused and family systems needs are notably unmet. Recently published reviews of family interventions [8] [9] [10] [11] [12] [13] [14] show that interventions provided by health care often are characterized as psychoeducational versus relationship focused. Additionally, interventions are mostly directed towards the individual family member or "
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    ABSTRACT: Research shows that living with illness can be a distressing experience for the family and may result in suffering and reduced health. To meet families' needs, family systems intervention models are developed and employed in clinical contexts. For successful refinement and implementation it is important to understand how these models work. The aim of this study was therefore to describe the dialogue process and possible working mechanisms of one systems nursing intervention model, the Family Health Conversation model. A descriptive evaluation design was applied and 15 transcribed conversations with five families were analyzed within a hermeneutic tradition. Two types of interrelated dialogue events were identified: narrating and exploring. There was a flow between these events, a movement that was generated by the interaction between the participants. Our theoretically grounded interpretation showed that narrating, listening, and reconsidering in interaction may be understood as supporting family health by offering the families the opportunity to constitute self-identity and identity within the family, increasing the families' understanding of multiple ways of being and acting, to see new possibilities and to develop meaning and hope. Results from this study may hopefully contribute to the successful implementation of family systems interventions in education and clinical praxis.
    04/2014; 2014(1):547160. DOI:10.1155/2014/547160
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    • "Better understanding of these facts facilitates the assessment of the patient's needs and those of her/his family [9]. Interventions focused on family members benefit the patient, mainly in the area of depression and anxiety, and in connection with the relationship with the people closest to her/him [10]. Therefore, nursing activities should be targeted at enhancing social support from the patient's family members and assurance that the nursing staff consider them as active participants in care provision. "
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    ABSTRACT: The intervention Dying Care from the Nursing Intervention Classification (NIC) includes six activities to support family members. The aim of the study was to find out if nurses perform these activities, and whether they consider their introduction into contemporary nursing practice in the Czech Republic to be feasible. We used a quantitative approach in which we carried out a cross-sectional study, which incorporated a non-standardised structured questionnaire with two Likert scales. The 468 participants in the study were nurses from hospices, oncology departments, geriatric departments, long-term care facilities, homes for the elderly and home care agencies. The results showed that the nurses most often employ the activity Support the family's efforts to remain at the bedside (scale average 1.72) and Facilitate obtaining spiritual support for patient and family (scale average 2.06). The nurses also consider the introduction of these two activities into contemporary nursing practice to be feasible. One fifth of the nurses stated they always use the activity Include the family in care decisions and activities, as desired (scale average 2.38) and Encourage patient and family to share feelings about death (scale average 2.51). All the above mentioned activities were most frequently used by nurses in hospices. The results suggest that the importance of these activities is recognised by nurses across settings. However, they see the actual feasibility differently. This confirms the need to include family support in care for the dying even in the settings which primarily do not provide specialised palliative care.
    03/2014; 16(1):e24–e30. DOI:10.1016/j.kontakt.2013.12.001
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